Residential Care Facilities

1. Residential Care Facilities DRAFT PRESENTATION

2. Course Objectives • An understanding of the differing roles of Community Care Licensing, the State Fire Marshal and the local Authority Having Jurisdiction. • Dealing with Fire Inspectors. • An understanding of the various categories of Residential Care Facilities. • Important definitions. • Various limitations of law applicable to Residential Care Facilities. • Regulatory requirements based on occupancy. • General Hazards to consider and abate. • Important general changes in new code. • Carbon Monoxide detectors • Applicable SFM Code Interpretations. • Appeal process for fire-related issues • Ask questions anytime, but keep them pertinent to topic being discussed.

3. Previous Code Occupancy Classifications 2001 CBC R-2.1 (Seven or more non-ambulatory) R-2.1.1 (6 or less non-ambs) R-2.2 (Seven or more ambulatory – may have up to 6 non-ambs R-2.2.1 (6 or less ambs.- may include 2 non- amb.)

4. R-2.3 (Hospice, 7 or more bedridden.) R-2.3.1 (Hospice, 6 or less bedridden.) R-6.1 (Seven or more non-ambulatory) R-6.1.1 (6 or less non-ambulatory) R-6.2 (Seven or more ambulatory) R-6.2.1 (6 or less ambulatory) Inherent problems – different licensing agencies, different types of clients..

5. Occupancy Classifications 2007 CBCI-1, R-4, R3.1

6. Occupancy Classifications 2010 CBC R2.1, R-4, R3.1

7. Dealing With Fire Inspectors • RCF’s most misunderstood facilities for inspectors. • Inspector is there because of 850. • Inspector may not be familiar with previous SFM interpretations related to your facility. • Assist the inspector during inspection. • Learn during the process and ask questions as necessary. • Ask questions during exit interview. If not satisfied with answers, ask for specific code sections that relate to deficiencies. • Do not argue with inspector if you think regulations have been misapplied or if specific code information has not been provided. • Check the deficiencies against the handout info given in this class and if different, point out difference to inspector. Be tactful and diplomatic. • If inspector won’t budge and is wrong, ask if it is ok to talk with his supervisor. • If talking with supervisor won’t solve issue. Follow appeal process.

8. Occupancies DefinedR-2.1 Facilities housing more than six non-ambulatory or bedridden regardless of licensing agency. CBC 310.1 May include: Assisted living facilities, residential care facilities for the elderly, Adult residential homes, congregate living health facilities, group homes, residential care facilities for the chronically ill, halfway houses, community correctional centers, community treatment programs, drug and alcohol rehab programs and treatment facilities.

9. Group R-4 Facilities housing seven or more ambulatory – may have up to six non-ambulatory or bedridden; regardless of licensing agency. CBC 310.1 May include: Residential care facilities for the elderly, adult residential facilities, congregate living health facilities, group homes, halfway houses, community treatment programs, correction re-entry programs, alcohol and drug abuse recovery and treatment centers.

10. Group R-3.1Occupancies Defined Facilities housing six or less clients of any age. CBC Section 310.1 (Ambulatory, non-ambulatory or bedridden – regardless of licensing agency). May include: Adult residential facilities, Congregate living health facilities, foster homes, group homes, ICF-DDH’s (federal), ICF-DDN’s (federal), residential care facilities for the elderly, Small family homes & Residential care facilities for the chronically ill, halfway houses, etc.

11. R-4 R-3.1

12. Important General Changes SFM adopted 2007 California Building Code and Fire Code as of January 1, 2008. Further, they adopted 2010 CBC as of January 1, 2011. Bedridden are now allowed in all occupancies Bedridden resulted from passage of SB-1896 Who licenses facility is no longer an issue In small facilities, ambulatory status no longer an issue 850 process stays intact Bedridden definition modified. New 2010 CRC requires automatic sprinklers in new single family residences and town-houses. New 2010 CBC requires carbon monoxide detectors. New law now requires carbon monoxide detectors in existing dwelling units after July 1, 2011 and other dwelling units by 01/01/2013.

13. Definitions Existing means facilities licensed prior to January 1, 2011 are viewed, inspected and regulated under the 2001 or 2007 CBC standards. New means facilities licensed after January 1, 2011 are to meet current standards. Restraint CBC 202.4 – shall mean the physical retention of a person within a room, cell or holding facility by any means, or within a building by means of locked doors.

14. Bedridden [CBC 310.2] means a person, requiring assistance in turning and repositioning in bed, or being unable to independently transfer to and from bed, except in facilities with appropriate and sufficient care staff, mechanical devices if necessary, and safety precautions as determined in Title 22 regulations, by the Director of Social Services or his or her designated representative. H&S Code 1566.456. The Director of Social Services or his or her designated representative shall make the determination of the bedridden status of persons with or without developmental disabilities

15. Temporarily Bedridden Licensee shall notify AHJ within 48 hours. Clients are ok for 14 days; and up to 60 days with CCLD approval. Note: Clients may just require assistance in getting out of bed, but be otherwise ambulatory or they may be totally “bedridden”

16. Care and Supervision means any one or more of the following activities provided by a person or facility to meet the needs of the clients: Assistance in dressing, grooming, bathing and other personal hygiene Assistance in taking medication Central storage and/or distribution of medications Arrangement of and assistance with medical and dental care Maintenance of house rules for the protection of clients. Supervision of client schedules and activities Maintenance and /or supervision of client cash resources or property. Monitoring of food intake or special diets Providing basic services required by applicable law and regulation to be provided by the licensee in order to obtain and maintain a community-care facility license

17. Congregate Living Facility – A building or part thereof that contains sleeping units where residents share bathroom and/or kitchen facilities. Non-Ambulatory Persons are persons unable to leave a building unassisted under emergency conditions. It includes, but is not limited to, persons who depend on mechanical aids such as crutches, walkers and wheelchairs and any person who is unable to physically or mentally respond to a sensory signal approved by the State Fire Marshal or an oral instruction relating to fire danger. HS-13131 H&S 1566.45 (Rosenthal) (AB-762) Clients who are unable to independently transfer to and from a bed, but who do not need assistance to turn or reposition in bed shall be considered non-ambulatory. Effective 01/01/2010

18. The Director of Social Services or his or her designated representative shall make the determination of the ambulatory or non-ambulatory status of persons with or without developmental disabilities. Residential Care Facility for the Elderly (RCFE) shall mean a facility with a housing arrangement chosen voluntarily by persons 60 years of age or older, or their authorized representative. It may include persons under 60 if approved by DSS. H&S Code 1569.2

19. Residential Facility (RF) shall mean any family home, group care facility, or similar facility determined by the director of Social Services, for 24-hour nonmedical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual. H&S Code 1566 Residential Care Facilities – “Six or fewer persons” does not include the licensee or members of the licensee’s family or persons employed as facility staff.

20. Licensing Agencies Department of Social Services, Community Care Licensing Department of Developmental Services Department of Public Health Department of Corrections Department of Drug and Alcohol Rehabilitation

21. Department of Social Services has responsibility for: Determining resident ambulatory, non-ambulatory or bedridden status. Determining the facility staffing requirements for the type of clients for all shifts. The qualification of care givers that serve in that capacity

22. Licenses through Department of Social Services Residential Care Facilities (RCF) RCF for the Elderly (RCFE) Adult Residential Facilities (ARF) Group Homes RCF Chronically Ill Foster Homes

23. Department of Developmental Services Provides assistance to Dept. of Social Services to determine the ambulatory, non-ambulatory or bedridden status of persons with developmental disabilities.

24. Department of Health Services • Large facilities – hospitals, nursing homes, convalescent homes, rehabs, etc. • Small facilities – ICF-DDH, ICF-DDN.

25. Department of Public Health • CLF Terminally ill

26. Licenses through the Department of Corrections Community Correctional Centers Community Correctional Re-entry Centers Work Furlough Programs

27. Licenses through the Department of Drug and Alcohol Rehabilitation Halfway houses Alcoholism or drug abuse treatment facilities Community treatment programs 850 process is different….

28. Officeof the State Fire Marshal Writes Regulations For The Protection of Life And Property - H&S Code 13143 Shall provide interpretations for the regulations they write -H&S 13143.8 SFM Shall Prepare and Conduct Training Sessions – H&S 13144.5

29. How Do Local Fire Jurisdictions and SFM Get Involved? They are agents of the State Fire Marshal to enforce regulations They perform Pre-Inspections at the request of an applicant They conduct Fire Safety Inspections as requested by Licensing

30. Local Fire Authority Responsibility Assist the applicant with facility Pre-Inspections when requested Assist the applicant in obtaining a facility Fire Safety Clearance Review Plans for Code compliance Correctly apply the regulations of the State Fire Marshal in the CBC, SFM Care Facility Interpretations and Information Bulletins Perform inspections to verify compliance with applicable CBC regulations

31. Pre-Inspection Requests for All Facilities Can be used by any licensing agency Needs to state what the applicant is requesting: Ambulatory, Non-Ambulatory or Bedridden Number of clients DSS is in process of revising this form.

32. FireSafety Inspection Request State Form 850 can be used by any State Agency. It is not a State Fire Marshal form. Top of form is to be completed by Community Care Licensing for Residential Facilities and Residential Care Facilities for the Elderly Form states number and ambulatory status of clients Facility and contact information Fire Inspector inspection date and conditions Final inspection must be completed within 30 days. CBC 1.11.4.5

34. Abatement of Existing Hazards • Building construction must be maintained – • No holes on walls or ceiling. • Ceiling tiles are not missing or broken. • Fluorescent ceiling light panels are not broken or missing. • Wires or extension cords have not been run through the wall or ceiling from room to room. • Housekeeping. • Cooking and fires. • Inside storage of LPG!! • Security doors • Use of candles

35. Bars on Windows Title 19, CCR, Article 4

36. Smoke barrier wallsSection 709, CBC • Smoke barrier doors – Cross corridor. • Doors in actual smoke barrier. • Penetrations on smoke barrier at interstitial space.

37. Smoke AlarmsSection 907.2.10.1.2 CBC

38. Fire Protection Systems – Maintenance and Testing • Fire Alarm Systems – Chapter 4, Title 19, CCR. • Sprinkler Systems – Chapter 5,Title 19, CCR. • Emergency generators- Section 3.24, Title 19, CCR.

39. Decorations • Decorations in clients rooms • Decorations in hallways • Decorations in common areas…Regulations can be found in Title 19, CCR, Sections 3.08 and 3.14.

40. Heating the home • Weather getting cooler. Need for heat. • Heating equipment, space heaters and fireplaces caused 66,100 fires nationwide in 2009 – 480 deaths, 1,660 injuries and 1.1 billion in damage. • Space heaters are major culprits – 1/3 of fires. • All heaters need space. Keep 3’ to combustibles. • Use listed heaters. • Have qualified contractors install heaters. • Fuel-burning equipment – vented to outside. • Keep vents clear and unobstructed. • Maintain heating equipment and chimneys clean at all times • Do not place space heaters where children can access. • Use type of space heater that will turn off if tipped over. • Turn space heaters off when you leave a room, leave the home or go to sleep. • Do not store combustibles in your heater closet

41. Christmas Trees • Nationwide response to Christmas tree fires – average of 260 per year. • Average – 14 deaths & 13.8 million in property damage. • One out of five caused by a heat source too close to tree. • Artificial trees to be listed and certified as fire retardant. • Green trees – fresh green needles that do not fall when touched. • Before placing the tree, cut 1-2” from the base of the trunk. • Tree must be at least 3’ away from source of ignition and not blocking exits. • Add water to tree stand and add water daily. • Use lights that are listed and have small bulbs. • Never use lit candles to decorate trees. • Never use combustible decorations. • Always turn off Christmas tree lights before leaving house or going to bed. • After Christmas – get rid of tree when it begins dropping needles.

42. Flammable & Combustible Liquids • Flammable and combustible liquids are potential fuel sources for fires and are present in almost every facility. (spray paints, lighter fluids, paints). • It is actually the vapor created by flammable and combustible liquids that ignites and burns. • It is important to understand what materials in your home are flammable and combustible so that you may properly store and isolate them from ignition sources

43. Storing Flammable and Combustible Liquids • Flammable liquids must be stored away from ignition sources in cool, well ventilated areas away from incompatible materials • Limit the amount of flammable and combustible liquids to the minimum amount necessary. • As a general rule, flammable materials should stored in a metal storage cabinet. in approved flammable liquid storage cabinets

44. Fire Safety- Electrical Issues • Electrical hazards are the cause of numerous fires each year. Faulty electrical equipment or misuse of equipment produces heat and sparks that serve as ignition sources in the presence of flammable and combustible materials. • Examples of common ignition hazards: • overloading circuits • use of unapproved electrical devices • damaged or worn wiring

45. Extension Cords

46. Fire Extinguishers • Must be provided in all facilities. • Staff must be trained it their use. • Must be located within 75’ travel distance • Must be visible and accessible. • Should be mounted on wall or cabinet • Must be operable at all times.

47. Type “K” FireExtinguishers • Required for commercial kitchens. • Class “A”, “C”, and “K” fires. • 1.5 gal. of stored pressure PRX wet chemical extinguishing agent (40 sec. discharge time). • 10-12 ft. maximum effective range. • On Class “K” fires, don’t use until after fixed extinguishing system has activated. • Extinguishes by cooling and forming foam blanket to prevent re-ignition

48. The Requirements for New Facilities

49. Applicable Code Section • Applicable requirements for RCF’s found in CBC Section 425. • In 2010 Codes, requirements are still found in Section 425 • Changes in 2010 code – Biggest = I-1 goes back to R-2.1. Other classifications stay same. All requirements are the same. • Significant changes - 2010, Section 425.8.3.3- Note: A sliding glass door can be used as an exterior exit doorway as long as it is operable from the inside and outside and the clear width of the exitway is not less than 32 inches. • Also, 2010 California Residential Code adopted and requires sprinkler protection for new townhouses and single-family residences.

50. 308.2 Group R-2.1 Occupancy(formerly I-1) Definition – More than six non-ambulatory or bedridden clients. CBC 310.1 Minimum construction – Type V-A. Max. 10,500 sq. ft., 3 stories, CBC 425.3.1 & Table 503. Smoke barriers – Required when exceeding 6,000 sq. ft. Thermal barrier. CBC 425.5.1 & 425.5.2 Sprinklers – NFPA 13 throughout. CBC 903.2.8 Smoke alarms – Required unless you have an automatic fire alarm system as per 907.2.9.3.. Fire Alarms – Manual and automatic. (Exceptions – non-ambs on first story, sprinklered, manual fire alarm system & and smoke alarms) CBC 907.2.9.3. The devices on an automatic system shall be smoke detectors. Exits – At least two. CBC 425.8.2.